sub-saharan africa

sub-saharan africa

trends

Abstracted from UNAIDS AIDS Epidemic Update:December 2003

and Fact Sheet 2003:Sub-Saharan Africa

Sub-Saharan Africa continues to rank number 1 both in terms of new HIV infections as well high AIDS mortality. This region has a striking 26.6 million people living with HIV/AIDS. The epidemic is estimated to have claimed the lives of about 2.3 million people in 2003. It is also estimated that 3.2 million new infections occurred in this region in 2003 alone.

In addition, a noticeable difference in this region is in the rate of infection of women in comparison to other regions. Women in Africa are estimated to be at least 1.2 times likelier than men to contract the virus. Young women aged 15-24 were found to be at least 2.5 times likelier to contract the virus in comparison to the male counterparts.

The prevalence of this disease is uneven throughout the region. Botswana and Swaziland have the highest HIV prevalence rate at 40% and Mauritania has the lowest prevalence rate at 1% Despite the fact that this region has less than 2% of the world's population, the region is home to more than 30% of people living with HIV/AIDS worldwide. More than one in five pregnant women are HIV-infected in most Southern African countries. Between 1997- 2002, a trend analysis of antenatal clinic sites in eight countries was conducted. The results revealed that HIV prevalence among pregnant women leveling off at almost 40% in Gaborone, Botswana and Manzini, Swaziland , and at almost 16% in Blantyre, Malawi, and 20% in Lusaka, Zambia. Prevalence exceeded 30% in South Africa's mainly urban Gauteng province while median HIV prevalence in Maputo, Mozambique was 18% in 2002. HIV prevalence in antenatal sites in Namibia rose to over 23% in 2002, while Lesotho's most recent data (collected in 2003) show median HIV prevalence among antenatal clinic attendees climbing to 30%. Several prevention efforts are underway in Southern Africa. However, there is no decline in the rate of new infections in this area. Malawi is one of the few areas that showed a decline in HIV prevalence among young women attending antenatal clinics. The figure was down to 15% in 2001 in comparison to 24% in 1996. It has been difficult to conclude if the reduction is a result of aberration or adoption of safe sexual practices.

The HIV prevalence rate in West Africa has shown stability. In Senegal , sustained program efforts have stabilized HIV prevalence levels among pregnant women at around 1% since 1990. Adult HIV prevalence levels remain low in other countries of the Sahel--around 2% in Mali , and 1% or lower in Gambia, Mauritania, and Niger. Burkina Faso and Ghana show stable trends: median HIV prevalence among pregnant women attending antenatal clinics has fluctuated between 2% and just over 3% since 1994 and barely exceeding 4% in the capital, Accra, in 2002. Côte d'Ivoire still has the highest HIV prevalence in West Africa. In some of the country's regions, more than 1 in 10 pregnant women have HIV infections, although in 2002, HIV prevalence among pregnant women in Abidjan dropped to its lowest level--7%--for a decade. Nigeria's most recent surveillance data (2001) suggest an anomaly, with the country's major cities having a lower HIV prevalence (below 5%, in fact) than several smaller cities classified as rural--most noticeably in the south.

East Africa and parts of Central Africa have lowered their HIV prevalence rate.. Uganda continued to show a downward trend in HIV prevalence. The prevalence rate has fallen down to a remarkable 8% in 2002 in comparison to a 30% a decade ago based on a survey done at two urban antenatal clinics in Kampala. The entire country of Uganda shares a similar story. This achievement has not been matched by any other country in the continent. However, the proportion of HIV-positive pregnant women in antenatal clinic sites has fallen to 13% in Kigali, Rwanda from a high of almost 35% in 1993 and in Addis Ababa, Ethiopia, among 15-24-year-old pregnant women, HIV prevalence has dropped almost as sharply--down to about 11% in 2003 after having peaked at approximately 24% in 1995. HIV prevalence in pregnant women has remained at low levels in Kinshasa, Democratic Republic of the Congo.

analysis:trends